Dietary Guidelines for Alcohol
Drinking in Moderation
- Alcohol consumption is associated with a variety of short- and long-term health risks, including motor vehicle crashes, violence, sexual risk behaviors, high blood pressure, and various cancers (e.g., breast cancer).1
- The risk of these harms increases with the amount of alcohol you drink. For some conditions, like some cancers, the risk increases even at very low levels of alcohol consumption (less than1 drink).2,3
- To reduce the risk of alcohol-related harms, the 2015-2020 U.S. Dietary Guidelines for Americans recommends that if alcohol is consumed, it should be consumed in moderation—up to one drink per day for women and two drinks per day for men—and only by adults of legal drinking age. This is not intended as an average over several days, but rather the amount consumed on any single day.4 The Guidelines also do not recommend that individuals who do not drink alcohol start drinking for any reason.4
- Two in three adult drinkers report drinking above moderate levels at least once a month.5
People Who Shouldn’t Drink At All
The Guidelines also note that some people should not drink alcohol at all, including:
- Women who are or may be pregnant.
- People younger than age 21.
- People who have certain medical conditions or are taking certain medications that can interact with alcohol.
- Recovering alcoholics or people unable to control the amount they drink.
- People who are doing things that require skill, coordination, and alertness, such as driving a car.
- The Guidelines also state that women who are breastfeeding should talk with their health care provider about alcohol consumption.4
Science around Moderate Alcohol Consumption
- For some conditions, such as certain types of cancer (e.g., breast cancer) and liver disease, there is no known safe level of alcohol consumption.2,3
- Although past studies have indicated that moderate alcohol consumption has protective health benefits (e.g., reducing risk of heart disease), recent studies show this may not be true.6-10 While some studies have found improved health outcomes among moderate drinkers, it’s impossible to conclude whether these improved outcomes are due to moderate alcohol consumption or other differences in behaviors or genetics between people who drink moderately and people who don’t.6-10
- Most U.S. adults who drink don’t drink every day.11 That’s why it’s important to focus on the amount people drink on the days that they drink.
- Drinking at levels above the moderate drinking guidelines significantly increases the risk of short-term harms, such as injuries, as well as the risk of long-term chronic health problems, such as some types of cancer.1,12,13
- Centers for Disease Control and Prevention. Alcohol Use and Your Health. Available at http://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm.
- Di Castelnuovo A, Costanzo S, Bagnardi V, Donati M, Iacoviello L, de Gaetano G. Alcohol Dosing and Total Mortality in Men and Womenexternal icon. Arch Intern Med 2006;166(22):2437-45.
- Rehm J, Shield K. Alcohol consumption. In: Stewart BW, Wild CB, eds. World Cancer Report 2014external icon. Lyon, France: International Agency for Research on Cancer; 2014
- U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015 – 2020 Dietary Guidelines for Americans.external icon 8th Edition, Washington, DC; 2015.
- Henley SJ, Kanny D, Roland KB, et al. Alcohol control efforts in comprehensive cancer control plans and alcohol use among adults in the United Statesexternal icon. Alcohol Alcohol 2014;49(6):661-7.
- Chikritzhs T, Fillmore K, Stockwell T. A healthy dose of skepticism: four good reasons to think again about protective effects of alcohol on coronary heart diseaseexternal icon. Drug Alcohol Rev 2009;28:441–4.
- Andréasson S, Chikritzhs T, Dangardt F, Holder H, Naimi T, Stockwell T. Evidence about health effects of “moderate” alcohol consumption: reasons for skepticism and public health implications.pdf icon[PDF-9.44 MB]external icon . In: Alcohol and Society 2014. Stockholm: IOGT-NTO & Swedish Society of Medicine, 2014.
- Knott CS, Coombs N, Stamatakis E, Biddulph JP. All cause mortality and the case for age specific alcohol consumption guidelines: pooled analyses of up to 10 population based cohortsexternal icon. BMJ 2015;350:h384.
- Holmes MV, Dale CE, Zuccolo L, et al. Association between alcohol and cardiovascular disease: Mendelian randomisation analysis based on individual participant data.external icon BMJ 2014;349:g4164
- Naimi TS, Brown DW, Brewer RD, et al. Cardiovascular risk factors and confounders among nondrinking and moderate-drinking US adultsexternal icon. Am J Prev Med 2005;28(4):369–73.
- Naimi TS. “Gray area” alcohol consumption and the U.S. Dietary Guidelines: a comment on Dawson and Grantexternal icon. J Stud Alcohol Drug 2011;72:687.
- Vinson DC, Maclure M, Reidinger C, Smith GS. A population-based case-crossover and case-control study of alcohol and the risk of injury.external icon J Stud Alcohol Drugs 2003;64:358-66.
- Nelson DE, Jarman DW, Rehm J, et al. Alcohol-attributable cancer deaths and years of potential life lost in the United States.external icon Am J Public Health 2013;103(4):641-8.
Page last reviewed: December 30, 2019